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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST
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BRANTLEY, ELISE IRENE
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
3030 NW 149TH ST
OKLAHOMA CITY OK 73134
Address last updated on 4/3/2024 |
| Phone #: |
(405) 562-6222 |
| Fax #: |
(405) 562-6522 |
| County: |
OKLAHOMA |
| License: |
28488 |
| Dated: |
6/10/2011 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Dermatology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
5 /
2005 |
| CME Year: |
2026 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF DERMATOLOGY |
| New Patients: |
Yes |
| Medicaid: |
No |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
CompMed
Coventry Health Care National Network
First Health
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Medicare Blue
Multiplan PPO
Oklahoma Health Network PPO
One Health Plan PPO
OSMA Health (formerly Plico PPO)
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
None listed |
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